Expander and Prosthesis

About Skin Expander and Prosthesis

Breast reconstruction by means of expander and prosthesis is not the only available option, but the one more often used by the majority of plastic surgeons and the most well known by patients. It requires a shorter operative time than autologous tissues procedures, but it is always necessary to perform it as a "delayed" procedure because it needs the expansion stage and then the replacement of the expander with a permanent prosthesis. Results are less natural if compared to breast reconstruction with DIEP flap, and may entail more complications because of the frequent phenomena of foreign body reaction to prosthesis. Nevertheless it remains a valid option in selected cases or when patient refuse other procedures.

Silicone gel filled prosthesis were firstly invented in United States, in the 60's of the last century. Later the well known conflict among their safety led United States authorities (FDA) to order a moratorium on the use of silicone gel filled prosthesis, waiting for larger clinical studies on their dangerousness (nowdays the absence of any link between silicone gel filled prosthesis and cancer relapse, other types of tumor or autoimmune disease, has been scientifically demonstrated, as firstly hypothesized). The moratorium gave a strong input to the research of new materials, improving body tolerance and aesthetic results, producing "anatomic" shaped implants and shells with different surfaces. Another important factor promoting the development of this tecnique was the manufacture of new and different types of expanders, necessary to recreate the room to locate the permanent prosthesis and to expand the toracic skin.

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Redazione Barbara Fabiani